Abstract: An intravascular device delivery system includes a distal end cap to connect an elongated member of the intravascular device delivery system to an intravascular device. The distal end cap includes at least one connection member radially movable relative to the distal end cap that is configured to engage with a complimentary recess in the intravascular device.

Abstract: Finger traps for collapsible suture loops are provided. In general, a suture coupled to an implant can be tensioned to facilitate desirable positioning of the implant relative to tissue in a patient's body. The suture can include a finger trap and a knot. In general, the finger trap is a hollow area of the suture through which the suture passes through itself and is configured to slide in a single direction when under tension. In an exemplary embodiment, the knot is located along a length of the suture that is closer than the finger trap to a tail of the suture that is being pulled to tension the suture.

Abstract: A suture member includes: a suture needle of which a distal end is sharp; a suture thread which includes a first end portion and a second end portion, of which the first end portion is connected to the suture needle, and which sutures the tissue; a first loop portion which has a ring shape, through which the suture needle is capable of passing, and which is connected to the second end portion; and a second loop portion which has a ring shape, through which the suture needle is capable of passing, which is connected to the second end portion, and which is provided to separate from the first loop.

Abstract: An apparatus includes a flexible fixation member having a body with a longitudinal extent and a width, the body defining a plurality of openings through the body, each of the plurality of openings formed substantially cross wise through the width of the body, and a suture having two terminal ends, the suture being interwoven through each of the plurality of openings in the body of the fixation member such that multiple portions of the fixation member are slidably coupled to the suture and configurable to form a cluster within a surgical site.

Abstract: A surgical suture is caught in a needle tip that is pierced through a body tissue; and when the needle is withdrawn, the surgical suture is pulled out along a path through which the needle was pierced into the tissue, and the surgical suture is tied outside a patient's body. The surgical suture for the laparoscopic port site closure device, wherein the laparoscopic port site closure device is in a tube shape for being introduced into a port site, includes: a tubular body provided with needle guides that face each other and guide insertion of a needle; wings mounted to a lower portion of the tubular body such that the wings are opened and closed through a cam method; and an operating stick penetrating through the tubular body to operate the wings to be opened and to be closed.

Abstract: A suture made of a woven braid of fibers is provided. The suture includes: at least one first end; at least one second end comprising a colorable material wherein the second end has been colored a single color along an entire length of the second end; and at least one third end comprising a colorable material wherein only a portion of the third end is colored a continuous color. In another embodiment, a method of manufacture of a suture is provided. The method includes: braiding an elongate suture from a first end, a second end comprising a colorable material, and a third end comprising a colorable material; coloring the second end a single first color along an entire length of the second end; coloring only a first portion of the third end a second color.

Abstract: An active anvil assembly for use in forming a looped suture is provided. The active anvil assembly includes an anvil member, a first sensor operably connected to the anvil member, and a control assembly. The first sensor is configured for measuring at least one of force, torque, and distance feedback. Also provided are systems and methods for forming a looped suture including an active anvil assembly.

Abstract: An arthroscopic anchor insertion tool and method for inserting consecutive, longitudinally aligned anchors from a common deployment channel of a cannulated needle by employing positive stops to prevent travel of an actuator from simultaneously advancing multiple anchors into a surgical site.

Abstract: Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair systems include self-cinching constructs with a fixation device, a flexible construct having a flexible strand abutting a suture tape, and a shuttle/pull device attached to the flexible strand and provided within the body of the fixation device. A splice is formed by pulling on the shuttle/pull device subsequent to the fixation device being secured into the bone, to allow the wide tape to be positioned over the tissue (for best compression and minimum tissue cut-thru) and suture for the implanted portion (for most efficient and least bone removal).

Abstract: Devices and methods for securing a graft with respect to bone are provided. One exemplary embodiment of a surgical implant includes a flexible filament body and a suture filament or repair construct that extends through the filament body at multiple locations. The repair construct is formed into one or more coils, which can receive a graft. The flexible filament body can be configured to be actuated between unstressed and anchoring configurations, the latter of which sets a location of the suture filament, and associated graft, in a bone tunnel. More particularly, the flexible filament body can ball up, or become denser, to a size that cannot pass into the bone tunnel in which the suture filament holding the graft is disposed. The present disclosure also provides for feedback units to assist a surgeon in knowing a location of the implant. Further, other exemplary devices and methods are provided.

Abstract: A suture passer comprising: a handle; a first needle mounted to the handle; a retrieving loop selectively extendable out of, and selectively retractable into, the first needle; a second needle mounted to the handle, the second needle being configured to pass suture therethrough; a housing having first and second lumens extending therethrough for receiving the first and second needles therein, respectively; wherein the suture passer is configured so that the first and second needles have (i) a first distance therebetween at the location at which the first and second needles pass through the housing, and (ii) a second distance therebetween at a location remote from the housing, and further wherein the second distance is greater than the first distance.

Abstract: Sutures with pre-tied knots for use in percutaneous surgical procedures and devices for easily and quickly tying complex suture knots are disclosed.

Abstract: Described herein are systems and methods for securing sutures that obviate the need for tying knots. A device can be applied to adjacent suture portions that heats the suture portions and causes the suture portions to fuse together, effectively securing the suture portions together without a knot. The device can include a handle, an outer shaft coupled to the handle, an inner shaft movable proximally and distally within the outer shaft; a suture holder at the distal end portion of the outer shaft, and an electrical heating element positioned within the outer shaft. Actuation of the device causes the inner shaft and the heating element to move distally relative to the outer shaft and the suture holder, such that the heating element moves into the proximity of the suture holder to fuse together sutures held by the suture holder.

Abstract: A graft suspension device for suspending a ligament in a bone hole having a first loop and a second loop suspending from an 8-hole anchor, and a cradle at the opposite end of the loops to the anchor. The loose ends of the suture are routed through holes in the anchor separate from the loops and are joined together to form a single tail. A finger loop allows a surgeon to adjust the distance of the cradle from the anchor with the cradle staying centered with respect to the anchor as the distance is adjusted.

Abstract: An insertion tool for a paddle lead includes an insertion tool body having a receiving end portion; a stylet channel extending along the insertion tool body; a stylet disposed in the stylet channel; and an actuator assembly disposed along the handling end portion of the insertion tool body and coupled to the stylet. The actuator assembly controls transitioning of the stylet between a first position and a second position. In some instances, the stylet can be a wire stylet that is inserted into a lumen in the paddle body of the paddle lead. In some instances, the stylet of the insertion tool pushes lead bodies of the paddle lead out of the insertion tool to release the paddle lead. In some instances, the insertion tool includes a paddle envelope to hold the paddle lead.

Abstract: The present invention relates, in part, to sutures which promote wound closure and/or healing. In particular, the present invention provides fibrin microthread sutures that mimic the mechanical behavior of a target tissue thereby reducing, for example, scarring, inflammation, and cell death at the ligature site, including monofilament sutures.

Abstract: An apparatus for repairing an anatomical tear, such as a tear in the meniscus of a human knee. The apparatus includes a guide cannula directing a penetrating shaft through the meniscal tear and through the outer skin layer of the knee. The penetrating shaft pulls a line to the outside of the skin layer of the knee where it is used to pull or kedge a repair implant into position across the meniscal tear.

Abstract: A method is provided for forming at least one curved polymeric microneedle, wherein the microneedle includes a base portion and an elongated body portion terminating in a sharp tip, said elongated body portion comprising a lower portion that is 15% to 25% of the height of the microneedle, said elongated body portion being connected to said base layer. The method comprises: heating an array comprising said base layer and at least a segment of said elongated body portion; passing the heated array against a fixed member to bend the microneedles; and allowing the bent, heated array to be cooled. The heat applied to the base layer and elongated body portion is sufficient to cause the heated microneedle to be at or above the glass transition temperature of the polymer of the microneedle, but below a temperature that would cause the lower portion to bend during the passing step.

Abstract: Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical soft tissue repair device includes a snare assembly coupled to a soft anchor in which the soft anchor has a first, unstressed configuration that can be used to insert the anchor into bone and a second, anchoring configuration that can be used to fixate the anchor in the bone. The snare assembly can be configured to actuate the anchor from the first configuration to the second configuration, and it can also be used to engage and approximate tissue by drawing the tissue closer to the anchor fixated in the bone. The snare assembly can be used in conjunction with a number of different anchor configurations, and other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Abstract: Systems and methods for soft tissue to bone repairs, without knot tying. Soft tissue repair systems include self-cinching constructs with a fixation device, a flexible strand with multiple flexible limbs, and a shuttle/pull device attached to the flexible strand to shuttle the multiple flexible limbs through the flexible strand and form a locking splice.

Abstract: A tissue fastener having fixed points of tissue attachment including a first elongate elastic component and a second elongate component having one or more elongate sections each adjacent section delineated by at least one frangible point.

Abstract: A rope and a method of constructing the rope. The rope may be of 12×12 braided construction and include a core for its length. The rope includes a plurality of primary strands, and each of the primary strands includes a plurality of fibers which may be made of a high-friction material. The rope also includes a secondary strand surrounded by the plurality of primary strands. The secondary strand includes a plurality of fibers which may be made of a low-friction material.

Abstract: A prosthetic heart valve includes a stent having a collapsed condition and an expanded condition. The stent has a proximal end, a distal end and a plurality of cells, each cell being formed by a plurality of struts. A valve assembly is secured to the stent and includes a cuff and a plurality of leaflets. The plurality of leaflets are attached to the cuff adjacent an underwire that extends about the perimeter of the cuff.

Abstract: A self-retaining suture having particular application for treating obstructive sleep apnea and use thereof. The suture includes rising an elongated suture body having a periphery and first and second tissue-penetrating ends each with a bi-curve needle, and a plurality of first retainers on a first segment and oriented to the first end, and a plurality of second retainers a second segment and oriented to the second end, and a retainer-free transition segment disposed between the pluralities of first and second retainers.

Abstract: Assemblies and methods suitable for knotless arthroscopic repair of tissue defects include two fixation members coupled by two limbs of suture comprising a continuous loop. A unidirectional restriction element that can be a preformed locking, sliding suture knot proximate to one of the fixation members, provides tensioning of the repair.

Abstract: A tissue fixation device including a self-locking construct having a first loop, a second loop, and a first free end. A first tail is coupled to, and extends from, the first loop. A second tail is coupled to, and extends from, the second loop. An anchor is coupled to one of the self-locking construct or the first tail such that one of the self-locking construct or the first tail extend through the anchor.

Abstract: A method to perform mini-invasive vaginal ostium plastic surgery and anal tightening procedures, includes: using at least one barbed cylindrical suture with barbs divided into two divergent groups, the sharp ends of the barbs being inclined in the direction of the respective ends, so as to oppose the traction of the thread exerted on both ends, each end being provided with a needle; preparing insertion and emergence cuts in the working plane of the female perineum; introducing the barbed suture thread by inserting needles placed at its ends, at different times, into the same starting hole, in order to emerge from the same outlet hole, thus completing the path in different anatomical planes of the female perineum; tying together the two ends of the at least one suture after having emerged from the same outlet hole, then closing the loop with at least one knot.

Abstract: Absorbable composite medical devices such as surgical meshes and braided sutures, which display two or more absorption/biodegradation and breaking strength retention profiles and exhibit unique properties in different clinical settings, are made using combinations of at least two types of yarns having distinctly different physicochemical and biological properties and incorporate in the subject construct special designs to provide a range of unique properties as clinically useful implants.

Abstract: An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

Abstract: In accordance with embodiments of the present invention, soft suture anchors are provided that are made entirely of biocompatible suture material. In accordance with embodiments, soft suture anchors are provided that when deployed, an anchor engages a pilot hole.

Abstract: An anchoring device having an elongate body at a proximal portion, a distal portion of the elongate body forming a loop at a distal portion of the anchoring device, and a pledget placed over the elongate body adjacent a proximal portion of the loop. The loop further includes a plurality of anchors disposed along a surface thereof and the loop. Methods for securing anchoring devices of the present disclosure are also disclosed.

Abstract: Embodiments of apparatus and methods for tissue lifting, or for correcting a ptosis condition caused by tissue stretching, are described. In some embodiments a tissue is supported by a support member. In some embodiments, tension is applied to a support member through at least one suspension member. The described embodiments provide examples of methods and apparatus effective for use in lifting or otherwise applying tension to various tissues, including tissues of the breast, buttock, thigh, arm, abdomen, neck and face.

Abstract: A method for coupling tissue includes aligning a guide tool on an outer surface of a first tissue; forming a bore in the first tissue aligned with the guide tool; deploying a non-slip suture construct through the guide tool and into the bore; adjusting a saddle along a flexible member to a position adjacent to a soft anchor, wherein the saddle prevents the flexible member from slideably moving relative to the soft anchor; and threading the flexible member through a second tissue to secure the second tissue to the first tissue.

Abstract: An embodiment includes a chordal replacement system comprising: a pledget coupled to a first suture length and at least one of a first needle and a first ferrule; a second suture length coupled to the pledget and at least a second needle; and a third suture length coupled to the pledget and at least a third needle; wherein the second and third suture lengths are not monolithic with each other and do not constitute a single suture. Other embodiments are described herein.

Abstract: A method for making an expanded, and optionally multi-component and/or colored PTFE monofilament is disclosed. The method includes forming a first paste by mixing a PTFE powder with a hydrocarbon solvent; forming an extrusion preform by pressing the first paste into a form; curing the extrusion preform by exposing the extrusion preform to a first temperature for a first time duration; forming a green monofilament by extruding the first paste through a die; expanding the green monofilament by exposing the green monofilament to a second temperature for a second time duration, the second time duration occurring after the first time duration; stretching the green monofilament substantially along a longitudinal axis of the green monofilament, the stretching the green monofilament occurring after the expanding the green monofilament; and sintering the green monofilament after the stretching the green monofilament.

Abstract: A barbed suture and a method of forming a barbed suture are disclosed. The barbed suture includes a core fiber and a sheet, which can be monolithic or formed from a plurality of longitudinally extending fibers, which is placed around the core fiber.

Abstract: A medical device for wound closure, e.g., repairing perforations and tissue wall defects. The medical device has a barbed elongate body and an outer member. The medical device may further include a foam structure. The medical device may also include an inner member which may be a tissue scaffold. A method for closing tissue is also disclosed.

Abstract: The present invention relates to a suture which is firmly maintained and fixed to an operation site to stably sustain suturing or lifting effects for a long time. More specifically, the present invention provides a suture having a conic or pyramidal shape with a cut top, wherein a suture supporter comprising a communication hole penetrating the both ends is provided at one end. The suture support can have one or more portions which are cut vertically from a lower end at a lower end portion having a larger diameter between the both ends, or a part of the lower end can be removed so as to form one or more gaps formed from the end at a wall of the end portion.

Abstract: A suture and a suture retainer are positioned relative to body tissue. Ultrasonic vibratory energy is utilized to heat the suture retainer and effect a bonding of portions of the suture retainer to each other and/or to the suture. Portions of the body tissue may be pressed into linear apposition with each other and held in place by cooperation between the suture and the suture retainer. The suture retainer may include one or more portions between which the suture extends. The suture retainer may include sections which have surface areas which are bonded together. If desired, the suture may be wrapped around one of the sections of the suture retainer. The suture retainer may be formed with a recess in which the suture is received. If desired, the suture retainer may be omitted and the sections of the suture bonded to each other.

Abstract: In one general aspect, an apparatus can include a mesh having an edge, a loop coupled to the edge of the mesh, and a suture coupled to at least one of the loop or the edge of the mesh, the suture having a barb. The loop can have an inner diameter smaller than a combined width of the suture and at least a portion of an outer portion of the barb.

Abstract: A medical device for installing sutures to close an incision in tissue or human skin is disclosed. The suturing device may provide first and second arcuate needles. Once properly positioned, the first and second arcuate needles are driven through the sub-dermal layer, or alternatively through a superficial surface, of two sections of skin to be joined. This is done in arcuate fashion and at identical and symmetrical rates of angular displacement. During the driving or retraction process of the first and second arcuate needles, a suture is positioned within both the first and second sections of skin and transformed from a planar or a multi-planar serpentine orientation to a helical orientation. The resulting suturing process is thus much faster than conventional or manual suturing and results in superior wound approximation/alignment that will lead to decreased scarring compared to prior art devices.

Abstract: Described are methods and systems for engaging sutures and anchors and the resulting suture and anchor sets. In certain aspects, an end of the suture may be heated to create a melted mass of suture material. The melted mass may act as a shoulder to resist backing out of a hole in the anchor through which the suture is threaded, thereby engaging the suture and the anchor. Adhesive material may optionally be used to enhance the engagement between the suture and anchor.

Abstract: An anchor is provided for placement in or against tissue. The anchor includes a fibrous construct and at least a first filament. Each filament passes through the construct in at least three passing locations including a first location nearest a first end of the construct, a last location nearest a second end of said construct, and at least one intermediate location between said first passing location and said last passing location. In an undeployed state, each filament extends a first length between said first location and said last location. In a deployed state, each filament extends a second length between the first location and the last location. The second length is shorter than said first length.

Abstract: Apparatus and methods for tissue fixation/attachment/reattachment using a knotless tensionable suture construct. The knotless tensionable suture construct is a self-tensioning suture loop that can be tensioned and retensioned after the repair and can be cycled few times. The self-tensioning suture loop is formed of: (i) a simple metal surgical needle with a thin loop off the base of it to allow suture to slide through it; (ii) a single strand of surgical suture which can be of various sizes and colors; (iii) a large knot which is tied to create a large bulge to fix the construct to the device (this can be a knot or secondary piece of material, like a button); (iv) a splice formed by the single strand of suture going back through itself, the splice locking the suture in place; and (v) a suture tail that is pulled to reduce the loop size of the construct and tension the repair.

Abstract: Barbed medical devices include a crown interconnecting a pair of legs and at least one barb extending from each of the legs. The at least one barb may define an inner surface with a first portion disposed at a first orientation relative to a longitudinal axis of the leg, a second portion disposed at a second orientation relative to the longitudinal axis, and optionally, a third portion disposed at a third orientation relative to the longitudinal axis of the leg.

Abstract: A suture stitch or a series of suture stitches with loops underneath and substantially parallel to the surface of a tissue for subcuticular suturing for reduced or minimized scarring and reduced suturing time. Each subsequent stitch connects with the previous suture through material across the diameter. The suture stitch or series of suture stitches include one or more knots acting as anchors for the first loop in the suture stitch or series of suture stitches, and the suture stitch or series of suture stitches are preferably administered via an automated suturing device.

Abstract: A flexible suture for coupling tissue includes a first suture portion extending to a first end and a second suture portion extending to a second end. A plurality of braided strands form the first and second suture portions. An identifier characteristic is formed into the plurality of braided strands. The identifier characteristic extends from the first end of the first suture portion to the second end of the second suture portion, and the identifier characteristic distinguishes the first suture portion from the second suture portion.

Abstract: Surgical articles, implants and components suitable creating composite slings are described. Novel procedures for assembling and utilizing composite slings are also detailed.

Abstract: A suspensory fixation device has an elongated anchor member adapted to be transversely situated at the exit of a bone tunnel. A graft supporting loop member formed of a pair of parallel suture limbs extending from a bight portion is suspended transversely from the anchor member and has a loop length which is adjustable so the graft ligament can be supported in the bone tunnel at varying distances from the anchor member. When a graft ligament is attached to the saddle end of the loop member, the length of the loop member may be shortened by simply pulling distally on the pair of limbs at one end of the loop member to pull the graft ligament into the bone tunnel a predetermined distance or until it bottoms out at the floor of the bone tunnel. When tension is applied to the loop member by the graft pulling the loop proximally, the bight portion of the suture automatically locks the graft supporting loop member in place.

Abstract: A barbed suture is provided. The barbed suture includes an elongate body and at least one barb extending from the elongate body. The elongate body defines a recess adjacent the at least one barb. Also provided is a method of making a barbed suture. The method includes the steps of providing a suture nest and a punch apparatus configured for operable engagement with the suture nest, loading a suture through the suture nest, engaging the punch apparatus with the suture nest, and disengaging the punch apparatus with the suture nest.